5 total
Application for accident benefits dismissed; injuries remained within the Minor Injury Guideline limits.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.
The Licence Appeal Tribunal found that the medical evidence, including insurer's examinations, confirmed the applicant sustained only soft tissue injuries.
The Tribunal concluded the applicant failed to demonstrate chronic pain with functional impairment or a psychological condition that would justify removal from the MIG.
As the $3,500 MIG limit had been exhausted, the disputed treatment plans and claim for interest were dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limit.
The applicant sought statutory accident benefits following a motor vehicle accident in 2016.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.
The applicant argued she suffered from chronic pain and psychological symptoms warranting removal from the MIG.
The Tribunal found the applicant's injuries were predominantly minor soft tissue injuries, relying on insurer examination reports that found no objective evidence of ongoing accident-related impairment.
The Tribunal concluded the applicant did not establish chronic pain with functional impairment or a psychological condition sufficient to remove her from the MIG.
The application for disputed treatment plans and interest was dismissed.
Applicant limited to Minor Injury Guideline cap; partial income replacement benefit awarded.
The applicant sought statutory accident benefits following a motor vehicle accident.
The adjudicator found that the applicant's injuries were predominantly minor, as he failed to establish a psychological impairment or chronic pain syndrome that would remove him from the Minor Injury Guideline.
Consequently, his medical and rehabilitation benefits were capped at $3,500, and his claims for further treatment were dismissed.
The adjudicator partially allowed the claim for an income replacement benefit, granting it for a limited period during which the applicant was substantially unable to perform the heavy physical tasks of his construction business.
The claim for HST on an income replacement report was denied, as the Schedule does not mandate HST payments beyond the statutory cap for such reports.
Applicant removed from Minor Injury Guideline due to pre-existing back condition; partial treatment benefits awarded.
The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.
The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant had a documented pre-existing back condition that prevented maximal medical recovery within the MIG limits, thus removing him from the MIG.
The Tribunal awarded the $1,280.00 treatment plan as reasonable and necessary, but denied the $1,600.00 plan due to a lack of supporting medical evidence.
Interest was awarded on the overdue benefits.
Applicant's injuries fell within the Minor Injury Guideline; claims for treatment plans and interest dismissed.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied the claims, determining the injuries fell within the Minor Injury Guideline (MIG).
The applicant applied to the Licence Appeal Tribunal, arguing that chronic pain and psychological impairments warranted removal from the MIG.
The Tribunal found that the medical evidence, including clinical notes and records, did not support a diagnosis of chronic pain with functional impairment or a psychological impairment.
The applicant's injuries were predominantly minor, and she was not entitled to the disputed treatment plans or interest.